title: Meta-analysis of associations of the ezrin gene with human osteosarcoma response to chemotherapy and prognosis.
abstract: Various studies examining the relationship between Ezrin overexpression and response to chemotherapy and clinical outcome in patients with osteosarcoma have yielded inconclusive results. We accordingly conducted a meta-analysis of 7 studies (n = 318 patients) that evaluated the correlation between Ezrin and histologic response to chemotherapy and clinical prognosis (death). Data were synthesized in receiver operating characteristic curves and with fixed-effects and random-effects likelihood ratios and risk ratios. Quantitative synthesis showed that Ezrin is not a prognostic factor for the response to chemotherapy. The positive likelihood ratio was 0.538 (95% confidence interval [95% CI], 0.296- 0.979; random-effects calculation), and the negative likelihood ratio was 2.151 (95% CI, 0.905- 5.114; random-effects calculations). There was some between-study heterogeneity, but no study showed strong discriminating ability. Conversely, Ezrin positive status tended to be associated with a lower 2-year survival (risk ratio, 2.45; 95% CI, 1.26-4.76; random-effects calculation) with some between-study heterogeneity that disappeared when only studies that employed immunohistochemistry were considered (risk ratio, 2.97; 95% CI, 2.01- 4.40; fixed-effects calculation). To conclude, Ezrin is not associated with the histologic response to chemotherapy in patients with osteosarcoma, whereas Ezrin positivity was associated with a lower 2-year survival rate regarding risk of death at 2 years. Expression change of Ezrin is an independent prognostic factor in patients with osteosarcoma.
authors.affiliation: Graduate School of Guangxi Medical University, Nanning, Guangxi, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
authors.forename: Mao-Lin
authors.initials: ML
authors.lastname: He
authors.forename: Jin-Min
authors.initials: JM
authors.lastname: Zhao
authors.forename: Hai-Hui
authors.initials: HH
authors.lastname: Qing
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
mesh_terms: D014408:Biomarkers, Tumor; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D003598:Cytoskeletal Proteins / Q000096:biosynthesis* / Q000235:genetics; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D016017:Odds Ratio; D012516:Osteosarcoma / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D012372:ROC Curve; D015996:Survival Rate; D016896:Treatment Outcome; D000099149:Ezrin
chemical_list: D014408:Biomarkers, Tumor; D003598:Cytoskeletal Proteins; D000099149:Ezrin